Test Prep MCQS Online Practice Questions and Exam Preparation

Test Prep MCQS Online Questions & Answers

• Question 181:

  A 10-year-old child has got progressive bilateral hearing loss. He has started to increase the TV volume. All other is normal.

  What is the most likely diagnosis?

  A. Wax
  B. Bilateral OM with effusion
  C. Foreign body
  D. Meningitis due to meningococcus
  B. Bilateral OM with effusion

• Question 182:

  A 60-year-old woman with metastatic breast cancer comes in with back pain. The spine is tender. She has hyperreflexia of the legs. What is the most urgent step?

  A. CT/MRI
  B. Steroids
  C. Biopsy
  D. Radiation
  D. Radiation

  ---

  The most urgent step in the management of cord compression is to administer steroids as soon as possible and to relieve pressure on the cord. Imaging studies are done after steroids are given, if the diagnosis of cord compression is clear (as it is in this case with pain, tenderness, and signs of hyperreflexia in the legs).

• Question 183:

  Old patient complaining of bone and joint pain, bleeding, recurrent infections. Labs show: lymphocytosis, myelocytes 3%, and myeloblast 2%. What is the diagnosis?

  A. AML
  B. Thalassaemia
  C. Sickle cell anemia
  D. CML
  D. CML

  ---

  Most common in Old and with usually increased WBC count and massive splenomegaly and characterized by Philadelphia (Ph) chromosome in bone marrow cells. ALL is most common in children. AML has more than 20% blasts on Bone marrow. Tip: The above patient is presented with acute Blasts crisis.

• Question 184:

  Patient has history of parotid and salivary gland enlargement complains of dry eye, mouth and skin, lab results HLA-B8 and DR3 ANA positive, rheumatoid factor positive. What is the course of treatment?

  A. Plenty of oral fluid
  B. Physostigmin
  C. Eye drops with saliva replacement
  D. NSAID
  C. Eye drops with saliva replacement

• Question 185:

  A 20-year-old boy is hit by a car while riding his bicycle. He presents to the ED with severe groin pain after falling on the central bar of the bike. Physical examination reveals blood at the urethral meatus and a high-riding prostate. What is the most appropriate next step in the management of this patient?

  A. Get a retrograde urethrogram
  B. Discharge the patient with reassurance
  C. CBC and electrolytes
  D. Empiric antibiotics
  A. Get a retrograde urethrogram

  ---

  The patient has a urethral disruption that needs to be evaluated. A kidney, ureters, and bladder (KUB) x-ray followed by a retrograde urethrogram must be conducted prior to any other tests. Placing a Foley catheter without such an imaging modality can lead to further urethral damage. The step after urethrogram is a Foley catheter placement to aid in urination. There is no role for antibiotics for trauma without evidence of infection.

• Question 186:

  A young boy presented with pain, swelling and redness of right side testes and scrotum. Sudden onset pain relieved on uplifting the scrotum.

  What would be the diagnosis?

  A. Torsion testes
  B. Inguinal hernia
  C. Hydrocele
  D. Epididymo-orchitis
  D. Epididymo-orchitis

  ---

  According to Prehn's sign, the physical lifting of the testicles relieves the pain of epididymitis but not pain caused by testicular torsion. Negative Prehn's sign indicates no pain relief with lifting the affected testicle, which points towards testicular torsion which is a surgical emergency

• Question 187:

  60-year-old male complains of decreased libido, decreased ejaculation, FBS= 6.5 mmol, increased prolactin, normal FSH and LH.

  What is the next step?

  A. Testosterone level
  B. DM
  C. CT of the head
  D. NL FBG
  C. CT of the head

  ---

  Prolactinoma is the most common tumor of pituitary gland, comprising up to 45% of all pituitary tumors. Prolactinoma is the most common cause of hyperprolactinemia, which is a common cause of infertility in males and females. Clinical presentation of the prolactinomas are earlier in females compared with males, even when they are very small (microadenoma). This earlier presentation in females is due to greater symptom burden caused by hyperprolactinemia in them.[1] On the other hand, males present late till prolactinoma becomes large in size (macroprolactinoma) and start causing pressure over optic chiasm and presented as visual deterioration or visual field defects. They can also present with decreased libido. So clinical diagnosis of prolactinoma in male patents is late, which can lead to misdiagnosis of microprolactinoma in male patients.

  Reference: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3205532/

• Question 188:

  Drug of choice of generalized anxiety disorder is ______________.

  A. Acetalopram
  B. Bubropion
  C. Buspirone
  D. beta blocker
  A. Acetalopram

  ---

  What is Citalopram an antidepressant in a group of drugs called selective serotonin reuptake inhibitors (SSRIs). Citalopram is used to treat depression. Treatment for Anxiety Disorders Many variables influence the selection of medication for individual patients. The following is general information regarding beginning treatment. Most common - sertraline (Zoloft), citalopram (Celexa), and escitalopram (Lexapro). These allow a low starting dose (12.5mg of Zoloft, 5mg of Celexa) and slow titration (anxiety patients are very vulnerable to initial activation and worsening of symptoms). Effective ranges: 50-200 mg of Zoloft, 20- 40 mg of Celexa, and 10-20 mg of Lexapro. We routinely utilize much higher doses than those previously listed to treat OCD. We rarely use benzodiazepines as first line drugs for these disorders and generally discourage as needed/rescue use. Benzodiazepines remain widely used drugs for panic and other anxiety disorders in both primary care and mental health settings. While they have clear value in some circumstances, we avoid them as first line treatments because they so powerfully reinforce the anxious patient's wish for a simple and quick way to avoid the distressing experience of his or her anxiety. Overcoming this desire to flee distressing circumstances or feelings is the bedrock of CBT and is absolutely critical to successful long-term outcomes. Benzodiazepines often make these efforts more difficult.

• Question 189:

  A 45-year-old male, known case of Hypertension and type 2 diabetes on oral metformin 1000mg B FBS 110, and RBS 140, his HBAIC is more than 8%, what should be his HBA1C by American Diabetic guideline:

  A. Less than 7.5
  B. Less than 7.0
  C. Less than 5.5
  D. Less than 6.0
  D. Less than 6.0

• Question 190:

  Chronic pancreatitis, investigation of choice?

  A. ERCP
  B. MRCP
  C. MRI
  D. CECT
  A. ERCP